| Azalea Therapy And Consultation Services | |
|
7264 N Sheldon Rd Canton MI 48187-2150 | |
| (734) 787-5872 | |
| Not Available |
| Full Name | Azalea Therapy And Consultation Services |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 7264 N Sheldon Rd, Canton, Michigan |
| Authorized Official Name and Position | Laura Jennings (OWNER) |
| Authorized Official Contact | 7347875872 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Azalea Therapy And Consultation Services 7264 N Sheldon Rd Canton MI 48187-3973 Ph: (734) 787-5872 | Azalea Therapy And Consultation Services 7264 N Sheldon Rd Canton MI 48187-2150 Ph: (734) 787-5872 |
| NPI Number | 1245759448 |
|---|---|
| Provider Enumeration Date | 09/19/2017 |
| Last Update Date | 06/08/2021 |
| Certification Date | 06/08/2021 |
| Medicare PECOS PAC ID | 1951661719 |
|---|---|
| Medicare Enrollment ID | O20180216000467 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245759448 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Laura E Jennings |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326453523 PECOS PAC ID: 0749551497 Enrollment ID: I20170731000562 |
| Provider Name | Pamela Grzech |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144840752 PECOS PAC ID: 2567874498 Enrollment ID: I20201216003056 |
| Provider Name | Katherine Reeber |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730588765 PECOS PAC ID: 5496149106 Enrollment ID: I20220223000968 |
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